The association between body mass index and increased utilization of healthcare services: a retrospective cohort study of 51,521 young adult males.

Objective: To examine the association between the entire body mass index (BMI) range and healthcare utilization.

Methods: Weight and height were measured during medical examinations of recruits prior to their entry into the military in Israel. All recruits were followed-up during service and all of their medical information was recorded in a central electronic medical record. We extracted medical and sociodemographic data for all Jewish male combat recruits during their first year of service. The study included 51,521 subjects who were divided into quintiles according to BMI. Using logistic regression models, we determined the association between BMI and high numbers of physician encounters, emergency room visits, referrals to specialists, imaging, laboratory tests, and medication prescriptions.

Results: In comparison with the lowest BMI quintile, there was a significant increase in the highest quintile with regard to an increased number of physician encounters (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19-1.36), emergency room visits (OR, 1.2; 95% CI, 1.12-1.29), referrals to specialists (OR, 1.22; 95% CI, 1.14-1.31), and medication prescriptions (OR, 1.23; 95% CI, 1.15-1.32). An increase in the number of laboratory tests was not statistically significant and there was no difference in imaging referrals. Adjustment for various sociodemographic variables and medical conditions did not significantly change the results.

Conclusion: Higher BMI is related to increased utilization of healthcare services, even for BMI values in the normal range.